Posts for tag: orthodontic treatment

If you've known anyone who has worn braces, you know what comes after — wearing a retainer. This can be kind of a letdown after all those months with braces, but it's absolutely necessary.

That's because teeth have a tendency to “rebound” to their pre-orthodontic positions once the force to move them stops after the braces are removed. Retainers help keep or “retain” moved teeth in their new positions and prevent them from reverting to the old.

When you think “retainer,” you probably picture a removable appliance with a wire that fits over the front of the teeth. While that may be the most common type, it isn't the only one. There's another called a bonded retainer, a thin piece of wire bonded to the back of the teeth that need to be retained. Unlike the other type, a dentist must remove a bonded retainer when it's no longer needed.

The biggest advantage of a bonded retainer is its invisibility — the wire is behind the teeth so no one can see it as with a removable retainer. The wire is bonded to the teeth with a dental composite material and then light-cured to create a strong attachment.

Another advantage is especially pertinent to younger patients. Because it's permanently attached and can't be taken out, there's no constant reminding of the patient to wear it — and no more worries about replacing a lost one.

They can, though, be difficult to floss around leading to potential plaque buildup that increases disease risk. It's very important you receive proper hygiene instruction for cleaning under the bonded retainer. Another concern is that they can break under excessive chewing pressure. And as with the more common retainer, we wouldn't want to remove it as that will result in the teeth's relapse to their old positions.

To learn which retainer is best for your situation, you should discuss the options with your orthodontist. Regardless of which type you choose, though, a retainer is a must for protecting your investment in that new smile.

Many otherwise attractive smiles have one noticeable blemish — a large gap between the two upper front teeth. If you have such a gap, there’s a solution that could transform your smile.

The most likely reason for the gap is an issue with a bit of muscle tissue between the gums and upper lip known as the frenum, part of the face’s muscular system. The frenum, though, can overdevelop and grow between the two front teeth into the front part of the palate (roof of the mouth). This can keep or push the teeth apart to form a gap.

To correct the issue, it’s first necessary to consult with an orthodontist, a specialist in bites and tooth alignment. It’s possible for there to be other factors contributing to the spacing including tongue thrusting or finger sucking habits, or missing or misaligned teeth. If the examination reveals an overly large frenum, then the treatment usually commences in two stages.

First, we would need to close the gap by the moving the teeth toward each other with some form of orthodontic appliance like braces or clear aligners. Once closed, the next stage would be to surgically remove the excess frenum tissue and cosmetically alter the gums if necessary.

The order of treatment is important — if you remove the frenum tissue first, any resulting scar tissue could prevent closing the gap with orthodontics. Further, cosmetic surgery on the gums beforehand could result in the loss of the papillae, the small triangular gum tissue between teeth, which results in an unattractive “black” hole.

A frenectomy, the procedure to remove the excess frenum, is a relatively minor procedure that can be performed by a periodontist (gum specialist), oral surgeon, or a general dentist with surgical training. The area is numbed with a local anesthetic, the tissue dissected with a small scalpel, and the resulting small wound closed with a few stitches (another option is to use a surgical laser to remove the frenum). Healing should be complete in about a week with only minor discomfort.

Depending on your individual circumstance, full treatment can take time. But in the end these otherwise routine dental procedures can have a huge impact — a more attractive smile without the noticeable gap.

If you or a family member has problems with teeth alignment or your bite, you may be considering braces. This tried and true method can straighten out most smiles — but there's more to braces than you may realize.

For one thing, orthodontic treatment wouldn't work if it weren't for the natural mechanism for tooth movement that already exists in the mouth. It may seem your teeth are rigidly set in the jawbone but that's not how they maintain their attachment: that's the job of an elastic connective tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament has tiny fibers that attach to the tooth on one side and to the bone on the other to actually hold the teeth in place, much like a hammock secured between two posts.

The ligament attachment also allows the teeth to move incrementally in response to environmental factors or the aging process. We harness this natural movement ability with braces to move teeth to a more desirable position. We first attach small brackets to the front crowns of the teeth (the visible portion) and then string arch wires through them. We then attach the wires to anchor points where we can adjust the amount of tension they're exerting through the brackets against the teeth. By gradually increasing that tension, the teeth respond as they would when any force is applied against them and begin to move.

By precisely controlling that movement we can transform a patient's smile. But we believe the advantages are more than cosmetic: the teeth will function better and will be easier to care for and keep clean. These benefits, though, have to be balanced with heightened risks for root resorption (something that occurs only about 10% of the time) in which the ends of the roots can shrink, or loss of mineral content in teeth enamel where the hardware makes it more difficult to remove bacterial plaque. These risks can be reduced by closely monitoring dental health during the entire treatment process and through stepped up efforts in daily oral hygiene.

The starting point for deciding on an orthodontic treatment is a thorough dental examination with x-rays or CT scan imaging. Once we have a complete picture of your misalignment problems and any other extenuating circumstances, we can recommend a treatment plan just for you.

It’s a big moment after months of wearing braces to finally get a glimpse of your new smile. The crooked teeth and poor bite are gone — and in their place are beautiful, straight teeth!

If you’re not careful, though, your new look might not last. That’s because the natural mechanism we used to straighten your teeth may try to return them to their previous poor positions.

Contrary to what many people think, teeth aren’t rigidly set within the jaw bone. Instead, an elastic, fibrous tissue known as the periodontal ligament lies between the teeth and the bone and attaches to both with tiny fibers. Though quite secure, the attachment allows the teeth to move in very minute increments in response to growth or other changes in the mouth.

Orthodontic appliances like braces or clear aligners put pressure on the teeth in the direction we wish them to move. The bone dissolves on the side of the teeth where pressure is being applied or facing the direction of movement and then builds up on the other side where tension is occurring.

The ligament, though, has a kind of “muscle memory” for the teeth’s original position. Unless it’s prevented, this “memory” will pull the teeth back to where they used to be. All the time and effort involved with wearing braces will be lost.

That’s why it’s important for you to wear an appliance called a retainer after your braces have been removed. As the name implies, the appliance “retains” the teeth in their new position until it’s more permanently set. For most people, this means wearing it for twenty-four hours in the beginning, then later only a few hours a day or while you sleep.

The majority of younger patients eventually won’t need to wear a retainer once bone and facial growth has solidified their teeth’s new position. Older adults, though, may need to wear one from now on. Even so, it’s a relatively slight inconvenience to protect that beautiful, hard-won smile.